Document Detail

Creating a fair and just culture: one institution's pat toward organizational change.
MedLine Citation:
PMID:  18030864     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Health care organizations have begun to move toward a nonpunitive, or "blame-free," process when analyzing medical errors and near misses. The Dana-Farber Cancer Institute's (Boston) "Principles of a Fair and Just Culture," define for staff and managers behavioral expectations when an error occurs.
CREATING THE PRINCIPLES OF A FAIR AND JUST CULTURE: The principles focus not just on patient safety but on a culture of safety and transparency in all the organization's functional areas, including nonclinical departments such as information services, administration, and research.
INCORPORATING THE PRINCIPLES INTO PRACTICE: Introducing the principles is a gradual process, one that requires continual education and discussion among staff at all levels and a commitment to examining and changing many of the systems, policies, and procedures that guide the organization's work. A survey conducted in January 2007 revealed that the clinical areas had sustained higher-than-average scores and that the nonclinical areas showed improvement.
DISCUSSION: Changing a long-standing culture of blame, control, and disrespect to one that embraces principles of fairness and justice and standards of respectful behavior is a major undertaking. Educating and involving clinical and administrative leaders, who work directly with staff and play a pivotal role in translating the principles into practice, is especially important.
Maureen Connor; Deborah Duncombe; Emily Barclay; Sylvia Bartel; Charles Borden; Elizabeth Gross; Carol Miller; Patricia Reid Ponte
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Joint Commission journal on quality and patient safety / Joint Commission Resources     Volume:  33     ISSN:  1553-7250     ISO Abbreviation:  Jt Comm J Qual Patient Saf     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-11-22     Completed Date:  2008-01-29     Revised Date:  2013-07-15    
Medline Journal Info:
Nlm Unique ID:  101238023     Medline TA:  Jt Comm J Qual Patient Saf     Country:  United States    
Other Details:
Languages:  eng     Pagination:  617-24     Citation Subset:  IM    
Dana Farber Cancer Institute, Boston, USA.
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MeSH Terms
Cancer Care Facilities / organization & administration*,  standards
Guidelines as Topic
Inservice Training
Organizational Case Studies
Organizational Culture*
Organizational Innovation
Safety Management / organization & administration*
Social Justice
Staff Development

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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